Social determinants of health- Week 7 Flashcards
What are the WHOs 10 determinants of health?
1) Income and social protection,
2) Education,
3) Unemployment and job insecurity,
4) Working life conditions,
5) Food insecurity
6) Housing, basic amenities,
7) Early childhood development,
8) Social inclusion and non-discrimination,
9) Structural conflict,
10) Access to affordable health services of decent quality
What is NHS England’s definition of health inequalities?
- Health inequalities are unfair and avoidable differences in health across the population, and between different groups within society.
- Health inequalities rise because of the conditions which we are born in, grow, live, work and age.
What are some measures of inequalities?
- Social class,
- Financial measures such as benefits or free school meals,
- Age/life expectancy,
- Housing problems,
- Level of education,
- Mental health,
- Sexual orientation,
- Ethnic orientation,
- Gender,
- Geography and environmental factors
What is the social gradient?
-‘The social gradient in health is a term used to describe the phenomenon whereby people who are less advantaged in terms of socioeconomic position have worth health (and shorter lives) than those who are more advantaged’
What factors affect the social gradient?
- Stress,
- Early life,
- Social exclusion,
- Working conditions,
- Unemployment,
- Social support,
- Addiction,
- Healthy food,
- Transport policy
Factors which affect the social gradient can exist at multiple levels:
- Individually e.g. family is socially isolated,
- Local community e.g. neighbourhood is poor,
- Societal e.g. unemployment is at an all time high.
- They can be culmative= often disadvantages go together e.g. poor diet+ poor access to public transport.
How do these inequalities occur?
- Differences in the quality of care received within the healthcare system,
- Differences in access to health care, including preventative and curative services,
- Differences in life opportunities, exposures and stresses that result in differences in underlying health status.
What are the 6 Marmot Review recommendations?
1) Giving every child the best start in life (education)
2) Enabling all children, young people and adults to maximize their capabilities and have control over their lives,
3) Creating fair employment and good work for all,
4) Ensuring a healthy standard of living for all,
5) Creating and developing sustainable places and communities,
6) Strengthening the role and impact of ill-health prevention
What are the main causes of poverty?
- Unemployment or low paid work,
- Low levels of skills or education,
- An ineffective benefit system,
- High costs,
- Discrimination,
- Weak relationships,
- Abuse, trauma or chaotic lives
What are some of the main consequences of poverty?
- Health problems,
- Housing problems,
- Being a victim or perpetrator of crime,
- Drug or alcohol problems,
- Lower educational achievement,
- Poverty in later life,
- Homelessness,
- Teenage parenthood,
- Relationship and family problems,
- Biological effects
How can Geography influence poverty, health ?
- The explanation of geographical variations in health can usually be provided by the socio-economic characteristics of an area,
- People living in the most deprived areas often have poorer health than the rest of the population. This can be shown for various health indicators and areas,
- Geographical context does play a role,
- ‘Healthy Nations’
How can ethnicity influence poverty and health?
- Ethnicity is a fluid concept and takes a different meaning in different contexts, for example a person may consider themselves as Pakistani when filling out UK census, yet the same person may be considered Asian on the US survey or South Asian for example,
- Ethnicity may have implications for health e.g. (prone to certain illnesses or discrimination)
Key things about Gender and health:
- In the UK, mortality is greater in males than females at all ages. In youth and early adulthood males are more likely to die from motor accidents, other injuries such as fire, or drowning and from suicide.
- Across the whole adult life, mortality rates are higher for men than women for all major causes of death including cancers and cardiovascular disease.
- However women have much higher rates of disability, especially at older ages than men, and women haven more morbidity from poor mental health, especially those related to a anxiety or depressive disorder
- WHO(2008)suggests that gender differences are a result of both 1)Biology and .2)social factors- which are distinct roles roles and behaviours a man and woman are given
Key things about Sexual orientation and health:
- Gay and bisexual men or women generally have poorer health than others,
- Women who had sex with both genders had significantly lower Self Reported health than women who exclusively had sex with men or women,
- Strong evidence that gay and bisexual men are more likely to attempt suicide, self harm, smoke drink and take drugs,
- 1/3 of gay and bisexual men who have accessed healthcare services in the last year have had a negative experience related to their sexual orientation.
Why do these health inequalities exist?
- The withdrawal of care support to half a million elderly people since 2013,
- The effect of a million fewer social care visits being carried out every year,
- Cuts to NHS budget,
- Increased rates of bankruptcy,
- Decline in the quality of care homes,
- Rise in fuel poverty among the old,
- Cuts too and removal of disability benefits
